Dr. Donohue: Frequent urination interrupts sleep

DEAR DR. DONOHUE: I have a problem with having to get up an average of four times every night to urinate. I am 90 years old. I will be very grateful for your help. -- S.M.

ANSWER: One reason why older people have frequent nighttime trips to the bathroom has to do with a change in the production of a hormone called ADH (antidiuretic hormone). It slows urine production. At younger ages, more ADH is produced at night, and urine production slows. In older ages, less is produced at night. People make more urine and are forced to rise to empty their bladders. In addition, the bladder shrinks with age and holds less urine, and that adds to the problem. Some doctors give people with this problem the ADH hormone to take before sleep so they can have an uninterrupted night of rest.

There are other causes for this, too. In men, an enlarged prostate gland is the chief reason for nocturnal visits to the bathroom. In both men and women, an overactive bladder is another reason why people are roused from sleep to empty the bladder. The bladder's muscular walls contract violently with only a small amount of urine in the bladder, and that makes people dash to relieve themselves, night and day. Medicines can help control this.

If you are producing large volumes of urine, then diabetes, heart failure, kidney failure, low blood potassium or high blood calcium could be the problem. These conditions increase day and night frequency of urination.

It helps to cut down severely on the amount of fluid you drink after the evening meal. Don't drink alcohol or caffeinated beverages from late afternoon to bedtime.